Everything You Need to Know About Your Meds

Get must-know info about buying, taking and storing Rx and OTC drugs

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Medication is such a part of our everyday lives—about two-thirds of all Americans take at least one drug daily—yet so many of us don't understand important details about them. Research shows that 10 percent of all hospital admissions are the result of patients not taking meds correctly and that most people don't know the active ingredients in the OTC drugs they use. "In a perfect world, a discussion about drugs would be its own doctor visit, so you'd go over all the details," says Michael Cohen, RPh, a pharmacist and head of the Institute for Safe Medication Practices. Here's what you need to know to stay healthy and safe.

Some drugs are better absorbed by your body at various times of the day, says Gayle Cotchen, lead pharmacist at McGee-Womens Hospital of the University of Pittsburgh Medical Center. For example, certain cholesterol-lowering drugs like statins are best taken at night because that's when your body produces the largest amount of cholesterol. And some osteoporosis drugs like Actonel and Fosamax should be taken in the morning when you have time to sit upright for half an hour afterward, to reduce the risk of the drug irritating your esophagus.

Keep Meds Out of the Bathroom Cabinet

Yup, it's counterintuitive, kind of like saying don't put canned soup in the pantry—but that cabinet is really the last place drugs should be (even OTC ones like aspirin, ibuprofen and supplements). Heat, moisture and temperature change can all degrade medicines. Much better: the linen closet, the bedroom or any dry, cool place out of children's reach. If you need to tote your meds, don't carry them next to your body (in a pants or shirt pocket). Body heat can cause them to break down.

This can compromise the effectiveness of many medications. Slow-release drugs such as the sleep aid Ambien CR, for example, dissolve in your digestive tract gradually to keep a consistent dose over many hours. Crushing or splitting will interfere with this process. Other meds are coated so they won't cause stomach upset, and crushing or splitting them can destroy that coating. Always ask the pharmacist first if the medicine can be crushed. If not, you may be able to get it in another formulation such as a liquid. Buying higher-dose pills and splitting them in half can save money, but don't do it before asking your doctor whether it's safe.

OTC Drugs Aren't "Safer" than Rx Ones

"What distinguishes an over-the-counter drug from a prescription one is that the FDA concluded that it can be used safely without a doctor's supervision, and the instructions are basic enough that most people can understand and follow them on their own," explains Cohen. In fact, many OTC drugs were once prescription—including alli, Mucinex and Zyrtec. Often a prescription drug will be approved in a lower dose for OTC use (the case with orlistat, for example, which went OTC as alli). And remember: Even OTC drugs can cause side effects. For example, pseudoephedrine, an active ingredient in some cold meds, can speed up your heart rate, and too-high doses of some pain relievers have been linked to kidney and liver problems. Protecting yourself means reading and following all the directions.

Quitting a drug a day or two after you've been on it and feel better is a big mistake! It takes the full course of antibiotics, for example, to clear all of the bacteria out of your system. Stop too soon, and the infection can come back even worse than before. Not to mention that you'd be contributing to the growing problem of antibiotic resistance. This also applies to medications for chronic conditions like asthma, cholesterol or high blood pressure. "With some drugs, such as cholesterol-lowering ones, the harm of stopping isn't immediate, but could contribute to a heart attack down the road," says Edward Langston, MD, RPh, who practices family medicine and geriatrics in Lafayette, Indiana. In other cases, such as with asthma or depression, stopping a drug can have almost immediate consequences, like an asthma attack or severe withdrawal symptoms. Always check in with your doctor first. If cost is a factor, your doctor may have free samples, or your pharmacist can recommend assistance programs. You can find other prescription payment assistance programs at RxAssist.org.

Generic versions, or FDA-approved copies of brand-name drugs, can be cheaper, but a generic may have what's called a slightly higher or lower bioavailability— meaning the rate and extent to which your body can absorb the active ingredient. (There's an FDA-accepted range.) It may also have different additives or colors. With most medications, this doesn't impact effectiveness or side effects, says Sheila Weiss, RPh, a professor of epidemiology and director of the Center for Drug Safety at the University of Maryland School of Pharmacy in Baltimore. But with some—heart and blood-thinning medicines, for example—it does make a difference, and doctors usually recommend sticking to brand names in those cases. If you do opt for the generic for one of these types of drugs, your doctor may order a blood test a few days after you start the drug to see how much is getting into your bloodstream.

When you drop off a prescription, someone at the pharmacy electronically contacts your insurance company. If the medication your doctor prescribed isn't on your insurer's list of "covered" drugs (called a formulary), they may tell your pharmacist about a similar drug that is covered—the pharmacist should tell you about it—or require you to pay full price. Check your prescription before you leave the pharmacy. If it's not the medication your doctor prescribed, ask the pharmacist if your doctor approved an alternative. (You may have to call him and ask.) Sometimes the alternative listed on the formulary is equally effective and safe, but there are cases in which it's not. Two drugs may be quite similar, but one, for example, may cause side effects. Your doctor can appeal the health insurance company's decision, but you may have to pay out of pocket for the drug you want until the issue is resolved.

Newer Isn't Always Better

Prescription medications go through years of testing in thousands of patients before finally getting approved by the FDA. But because problems may not crop up until they're on the market, the FDA urges drug companies to continuously monitor a drug's safety and report back to the agency. If your doctor prescribes a drug that's just been approved, ask about it, says Dr. Langston. Is it better for your condition than what's currently available? Does it have fewer side effects? Often there's a reason it's worthwhile to try something new.

Just throwing drugs in the trash, especially in their original vials, creates the risk that kids or animals could find and swallow them. Flushing them down the toilet is also a bad idea, since that can contaminate the water supply and nearby fish streams. Check labels for specific instructions on how to dispose of the meds, and if there aren't any, follow these instructions: Take pills out of their original containers and mix them with coffee grounds or kitty litter; this makes it very unlikely that a child or animal will want to eat them. Then put them in a sealable bag or closed container before throwing them in the garbage. You can also call your city or county government's household trash and recycling service (see blue pages in the phone book) to find out if there's a take-back program available that will dispose of the meds for you.